What your hair and nails can tell you about your health

Dr Christine Reader

White spots? brittle nails? Hair falling out? Dr Christine Reader looks at what your nails and hair can tell you about your health.  

Our hair and nails are constantly growing. Every day is reflected in a tiny bit of growth and, as a result, they can give useful information about many illnesses such as an under active thyroid,  (hypothyroidism), psoriasis or diabetes to name a few.

And remember if you are worried, it’s always best to have any changes to your nails or hair health evaluated by a doctor.

Before we get onto what your hair and nails can tell you about your health, lets tackle the thorny question of whether or not you should be taking a vitamin supplement to help them grow.

Should you Supplement?

We’re often told that we need vitamin supplements for the healthiest hair and nails possible, but is that really the case? Well, the literature would suggest that in healthy people with normal levels of nutrition, taking additional vitamins to improve nail health is not really of benefit.

It is certainly true that deficiencies of certain vitamins and other nutrients do affect nail health and would then require treatment, but if you have a deficiency so severe it is best to be seen by your doctor. Never delay seeking professional help by treating yourself with supplements.

In general, healthy and well-nourished people don’t seem to gain much for their nails when taking additional supplements.

 

What can hair and nails tell us?

Brittle Nails

Brittle nails chip easily, or tend to bend, peel or even split. This may occur with certain illnesses, but the most common cause is ageing. Just as we get wrinkles, so our nails naturally become more brittle.

Another common cause is damage from the environment.

One easy way to tell if this is the case is if your toenails are strong, but the fingernails are brittle. If so it’s most likely that something external is damaging the nail. Nails that frequently get wet and dried can easily become brittle. Chemicals, detergents and soaps may also weaken the nail. So, basically, washing up is your nails’ worst nightmare. That’s why waterproof gloves (especially with a cotton lining) are advised.

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Another habit that can lead to brittle nails is the frequent use of nail polish and nail polish remover. It’s a good idea to give your nails a little break from polish sometimes, don’t peel the gel nails off (big no-no!) and apply lotion (lanolin if you’re not allergic).

There are plenty of conditions and diseases that cause brittle nails. A true vitamin deficiency (such as zinc, iron and/or Vitamin A) being one of them. Your doctor may investigate depending on additional symptoms.

Sometimes your doctor may advise a supplement

I know I mentioned before that taking additional vitamins don’t seem to make much difference in healthy people, but there are exceptions to this and here is one: The American Osteopathic College of Dermatology suggests that Biotin (a Vitamin B supplement) could be prescribed for brittle nails and can be of benefit to some people.

White Spots

The medical term for white spots in nails is leukonychia. It’s a very broad term that covers quite a few variations. However, what we may commonly see are the small very white spots. These are sometimes known as milk spots. The commonest cause is trauma. Simple things such as banging the nail or manicures may cause this, but also nail biting.

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The white will grow out with the nails, usually in about 6 months in the fingernails but may take a little longer in the toenails, which tend to grow more slowly.

Some other causes are fungal nail infections or a reaction to certain products, such as nail polish. Your doctor may investigate you for certain deficiencies (like calcium or zinc) or more serious illness depending on other symptoms.

Nail Ridges

Here, the direction of the ridges is a factor to consider. Horizontal ridges running from side to side can result from injury, such as pushing the cuticle back too hard. Interestingly, they may also appear a few weeks after having had a fever or being ill.

The vertical ridges that run from the cuticle to the tip of the nail are often normal with ageing. Both cases may sometimes result from underlying systemic or skin disease.

Tip: Resist the temptation to buff the nail too enthusiastically in the attempt to smooth it out. You may end up thinning the nail too much.

Nail Pitting

Little dents or ice pick-like depressions in the nails (nail pitting) can sometime give clues to underlying conditions including auto-immune conditions like alopecia areata (a form or hair loss), or connective tissue disorders like Reiter’s syndrome. They are are often seen in people who have the skin condition psoriasis. Sometimes nail pitting may also be found in healthy people too.

Beau’s lines

Beau’s lines are indentations that run from side to side across the nails. They basically  reflect a period in time where the growth of the nail has slowed down a little. They can also appear after an injury at the base of the nail or they can be caused by illnesses including uncontrolled diabetes, peripheral vascular disease, or if you’ve had a very a high fever. They can also be a sign of zinc deficiency.

Spoon nails

As the name suggests, spoon nails or koilonychia are nails that look like a spoon – they’re scooped out in the middle and raised at the sides.

Koilonychia is most commonly associated with an iron deficiency anaemia, but may also be found in other cases, such as protein deficiencies and connective tissue disease. Again, koilonychia may be a finding in some healthy people. Sometimes babies may appear to have spoon-shaped nails on the big toe.

 

Clubbed nails

Clubbed nails are sometimes hard to spot, as it may be subtle in some cases. It is where both the horizontal and vertical curvature of the nail increases and the soft tissue becomes a bit thicker.

Clubbing has many causes, but by far the most common are disorders of the heart and lungs, such as congenital heart conditions (those a birth), lung cancer, lung abscesses and many more. Some bowel conditions like inflammatory bowel disease may also cause this, as well as thyroid problems, to name a few.

Great Expectations – pregnancy

Pregnancy can cause a number of changes to your hair, skin and nails. While some women find their nails grow faster and feel stronger, some women experience less favourable nail changes.

Commonly, leukonychia and brittle nails. All should be back to normal about 6 months after baby has arrived. Similarly, menopause can go hand in hand with brittle nails.

Whilst on the topic of pregnancy, let’s have a look at hair. Many pregnant women tend to notice their hair seem fuller and even shinier. In pregnancy the growth phase of the hair becomes prolonged and we shed less – all thanks to being flooded with oestrogen. Brilliant. Some women even find that their hair texture changes.

These changes are usually temporary and start fizzling out after baby’s arrival. You may think you’re losing a lot of hair in comparison to while your were pregnant, but it’s quite normal. If you are concerned that it’s too much – see your doctor.

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Hair Loss

While we normally lose 50-100 strands of hair each day, hair loss happens when we lose much more than we grow back. It’s commonly associated with ageing, and not just in men. Additionally, there are many medical causes for hair loss, including medication and illness (examples are systemic thyroid problems or local fungal infections). So, best to see your doctor.

Periods of immense stress or weight loss have been known to trigger hair loss. It is a distressing experience and remember to seek help, there are treatment options.

Dry Hair

Some of us are naturally predisposed to dry hair, depending on hair type. Again, hair usually does become drier as we age. The hair cuticle is the outermost part of the hair and when the cuticle starts to peel away from the hair, the hair loses its sheen and loses its protective barrier. This also allows water in. Again, there are medical conditions, such as hypothyroidism, that can cause dry hair. Remember, see your doctor if you are concerned.

All that much being said, many of us are guilty of some common habits known to cause dry hair including:

  • Frequent washing. Daily washing is a no-no.
  • Activities where hair is wet, such as swimming. (Try and wear a cap and condition your hair well afterwards).
  • Heat from styling and drying and chemical processes like bleaching or perms.

Being a bit gentler when styling, and washing less frequently with a sulphate-free shampoo (the shampoo with less foam) can go a long way in reducing damage . Coconut oil can help keep hair a bit glossier.

As far as hair and nails go, they certainly do give away some clues about our general health and lifestyle, but the key to keeping them healthy is a varied diet.  Feed your body from inside out.  Looking after yourself goes a long way and, often, it really shows.

Dr Christine Reader is a medical practitioner who is taking a break from practising to concentrate on raising her family and writing.

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